NASHVILLE, TN (WGNS) - A major new study led by Vanderbilt Health researchers is shedding light on the medical conditions that tend to show up years before an Alzheimer’s diagnosis — and the list is far longer than previously known. The findings, published in Alzheimer’s Research & Therapy, could help shape earlier interventions aimed at reducing risk long before memory problems appear.
Alzheimer’s disease develops slowly over decades, and while conditions like hypertension, high cholesterol and stroke have long been linked to increased risk, researchers say the full picture has been incomplete. That’s what prompted Xue Zhong, PhD, a research assistant professor in Vanderbilt’s Division of Genetic Medicine and Clinical Pharmacology, to take a deeper look.
“If we know the full inventory of medical conditions that predict Alzheimer’s disease development 10 or more years later, we can potentially intervene before clinical symptoms become apparent,” Zhong said. “Delaying the onset by just five years could cut the incidence rate in half.”
Zhong and co‑corresponding author Nancy Cox, PhD, led a team that analyzed de‑identified electronic health records from two massive databases: MarketScan, which includes more than 150 million U.S. insurance claims, and Vanderbilt Health’s own EHR system, which covers roughly 3 million patients. Together, the datasets included more than 44,000 people diagnosed with Alzheimer’s and hundreds of thousands of matched controls.
By tracking medical histories over the decade leading up to diagnosis, the researchers identified more than 70 conditions that consistently appeared more often in people who later developed Alzheimer’s. The strongest patterns fell into four major groups: mental health conditions such as depression and severe neuropsychiatric symptoms; neurologic and sleep‑related issues including insomnia and sleep apnea; cardiovascular problems like hypertension and cerebral atherosclerosis; and metabolic conditions such as Type 2 diabetes.
To understand the genetic connections, the team also used data from Vanderbilt’s BioVU DNA biobank and the UK Biobank. They found 19 conditions tied either to specific genetic variants or to a broader polygenic risk score for Alzheimer’s.
The authors emphasize that these associations don’t prove causation, but they do offer a roadmap for earlier risk recognition and prevention‑focused research. Zhong noted that the study reinforces the importance of managing midlife hypertension and cholesterol — lifestyle changes and medications that may help reduce Alzheimer’s risk later on.
The team also confirmed an intriguing trend seen in earlier studies: an inverse association between cancer and Alzheimer’s. Researchers are now digging into the biology behind that pattern in hopes of uncovering new therapeutic clues.
